Implementation
The performance of a stool transplantation begins with the preparation of the stool of a healthy donor. For this purpose, the donor chair is diluted with a physiological saline solution and then filtered, which cleans it of superfluous components such as indigestible fiber and dead bacteria. In most cases, the suspension produced in this way is then introduced into the patient’s duodenum via a probe that has previously been placed by means of endoscopy (mirroring).
Another possibility is the introduction of the bacteria into the large intestine by means of colonoscopy. Research has been underway for several years now into stool transplantation using acid-resistant capsules. This form of therapy, which would replace the insertion of a probe into the duodenum under anesthesia, not only offers the prospect of less effort.
At the same time, stool transplants could be brought to market maturity by the creation of stool banks, as has happened in the USA in 2012, and thus be offered to a larger group of patients. In Germany, however, this form of microbiome transfer is still in its infancy. The first use of a capsule containing bacteria in Germany was successfully completed in Cologne in 2015. Since then, the development of frozen and therefore very long-lasting capsules has also been followed with great interest.
How do I find a clinic that performs a stool transplantation?
So far, a stool transplantation is only performed in selected centers in Germany and Austria. However, a large number of German university hospitals offer stool transplantation. In order to select a suitable clinic, one should first conduct an Internet search. The clinics often advertise on their Internet sites with the offer of a chair transplantation for certain diseases. When searching for a suitable clinic, however, one should take care that individual clinics only offer stool transplantation for specific indications (e.g. for therapy-refractory Clostridium difficile-associated diarrhea).
Is it possible to perform a stool transplantation yourself?
The costs of a stool transplant are currently not covered by either private or statutory health insurance companies, as the procedure is still in its early stages and investigations into the indication and success rate are not yet complete or are very incomplete. For this reason, the costs of the procedure must be borne by the patient himself. These are calculated on the one hand from the material costs of the stool preparation, which are between 100 and 200€, and on the other hand from the costs for the donor’s screening examinations, which are necessary in advance and which make up the largest part of the effort and can additionally amount to between 500 and 800€.
